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Breast biopsies and the like...when to say when...and how to get ins to do MRI's???

My first lump was discovered about oh...9 years ago when I was 27. Since then, I've had ultrasounds every 4-6 mos and many, many biopsies. Most of which were totally benign. Two of which showed concerning things. One was a few years ago and they had me do some treatment. That was the first one. The last one last fall they were "worried" about ductile tissue changes and wanted to do an MRI but my ins wouldn't do it and I didn't have the money.

I just got a call today from my Dr's office and it's time again for a recheck ultrasound. I am in a new state and have to find a new doc. From what i can tell, most of my issue is having not had kids and therefore everything is very dense and hard to read. So I can do the ultrasounds and they can find every lump and bump but it's not very specific. THen someone orders another biopsy.

I really don't want to keep doing biopsies as my last radiologist said "you keep doing this, you won't have any breasts left!" (he's right...I'm a generous A at best!)

It's not that I really care about keeping my boobs--they've done nothing for me frankly--but I do wish to keep the invasive procedures to a minimum...but I don't want to be flippant.

What I really need to do per the last few radiologists, is to just have an MRI. I have new ins now w/ the gov't so maybe it will all be different this time.

But who knows. Anyone done similar? I don't want to downplay being on top of things. THere is significant BC in my family history. I just don't want to keep doing these ultrasounds 3 times a year and biopsies along with them for naught. There HAS to be a better way, right?

A good horseman doesn't have to tell anyone...the horse already knows.

I know it's controversial and I don't know when doctors will offer it, but since you have the significant BC family history and lumps yourself, have you considered having mastectomies and just getting it over with? It would suck, but in your case I think I might prefer it to procedures 3x a year for the rest of the foreseeable future.

My mom actually said the same tonight, Redmare. No, I've not really considered it as I feel like it would be fairly extreme given the non-emergent situation that I'm in. However, if I ever really did have a major issue in one, I would take both as a precaution.

At this point though, I think that I'm having a lot of unnecessary procedblaures because the docs need to cover their butts. If they see ANYTHING (and there's plenty to see on ultrasound) they want to biopsy.

I'll be honest, at this point, I'm almost getting blase about it because it's so frequent and it's so frequently NOTHING to worry about. I would really like to try a more definitive screening method and get rid of the surgical component if possible.

A good horseman doesn't have to tell anyone...the horse already knows.

Fairfax Radiology is probably as good as it gets around here. They have all the diagnostic procedures including MRI available at a single location. Then you can take whatever they find to a specialist, of which there are many around here.

Thus do we growl that our big toes have, at this moment, been thrown up from below!

At this point though, I think that I'm having a lot of unnecessary procedures because the docs need to cover their butts. If they see ANYTHING (and there's plenty to see on ultrasound) they want to biopsy.

I had my first mammogram 2 years ago and got called back for an ultrasound for a lump that I had identified and went running off to the Dr for when I was about 19. The Radiologist said it was most likely nothing (she said she was "99.9% sure") based on the nature of the lump on the ultrasound but recommended I get a biopsy anyway. I chose not to do it because I just could not make myself worry about something that for the last 27 years, no Dr ever mentioned having itchecked past a regular breast exam in 27 subsequent years.

I just went for another mammogram today. I have found that in the long run it is quite stressful to ignore the recommendation for biopsy even though I do not agree with the CYA medicine.

You sort of get trapped in a damned if you do and damned if you don't scenario.

Op, I feel bad for you. A strong family history of breast cancer coupled with findings requiring biopsy every time out would drive me over the edge. I think I would be figuring out how to get rid of the damn things now. (I guess I say that but do not really know how I would feel in your shoes. )

I can see that life would be less stressful if they just took the damn lump out in my case, just to not stress about "keeping an eye on it". But I have no family history of breast cancer and I also have the lumpy, dense breasts.

I would be grateful if mammography caught something but I really find myself feeling resentful at the trap it presents.

The "better way" is often...to just not do them. Yes, there's a risk in that, but if you think of health care as a continuum with false positives and unnecessary procedures on the left, appropriate testing somewhere between, all the way through to no testing/false negatives/necessary procedures not done on the right, you're way way to the left.

Your main doctor has to be able to quantify the risk for you, and you have to make a decision. If there's a strong FHx of early breast cancer, maybe get the genetic test done; if it's BRCA a preventive mastectomy would not be out there. But otherwise the stats exist, your doc can at least let you know the population risk and you can decide whether you want your boobs cut up every few months, or if you want to stop the frequent screening. There's no perfect answer, just a risk/benefit calculation here.

You're so right about the "trap". You get checked on, they suspect something *maybe* and if you do and it's nothing well...sucks. But if you do nothing and it's something? Well that sucks too. I am just getting to the point where I assume it's nothing and I'm kind of tired of the surgical biopsies or the needle guided becuase the FNA isn't doing the trick. I really don't think there is a problem at this point. But I hate to look a gift horse in the mouth and all that. So I'll make an appt (thank you Lex for the link!) and I'll do it. And hope they will be conservative.....

A good horseman doesn't have to tell anyone...the horse already knows.

I understand your reluctance to get under the knife again... I had two biopsies before they diagnosed BC 13 years ago... I had a mastectomy and chose no reconstruction. I am glad I did because it came back... two biopsies (the fine needle which to me was a joke... it's a dart so where does it pick up the tissue? and of course, it was inconclusive...) luckily, when the real biopsy was done, the surgeon got it all with clear margins.... I am 4 treatments short of finishing radiation... No history at all in my family...I am the lucky one! I have 4 scars across my non existent breast now... sigh... Still, I would never ignore it...I am glad I never did!
Good luck.

Hmm...As someone who was diagnosed with breast cancer at age 24 with NO family history I would be inclined to say that you can't be too careful. But I do understand if you have had several false alarms how frustrating that would be.

I wanted a Ear/nose/throat exam but was frustrated with my dr, so went to Beth Israel web site, picked their top doctor and called. Receptionist said he only took referrals, but gave me the name of someone else. I googled her and paid out of pocket for an appointment. I got a endoscope and dx. It was worth it $400 and she nailed the problem. I can't tell you how satisfying that was. My regular doctor is constrained by his employers (physician run HMO) and is dismissive.